Moreover, improving gait speed reduces mortality in older adults. Blood pressure increases with advancing age, increasing cardiovascular morbidity and mortality. Changes in BP with aging exhibit marked heterogeneity as BP has distinct steady and pulsatile profiles. The steady component is largely influenced by cardiac output and peripheral vascular resistance. The pulsatile component reflects the integration of left ventricular systolic function, large-artery stiffness/impedance, forward wave pressure and pressure from wave reflections. While mean arterial pressure changes little in older adulthood, PP can increase substantially owing to increases in arterial stiffness/impedance, genesis of a larger forward pressure wave, and faster arrival of larger reflected pressure waves. In older adults, elevated PP increases risk for myocardial infarction, new-onset atrial fibrillation, heart failure and is in an independent predictor of coronary disease and cardiovascular mortality. Several lines of investigation support a physiologic link between ventricular-vascular function and physical function. Increased pulsatile pressure may reduce coronary perfusion, damage peripheral vessels reducing endothelial vasomotion and skeletal muscle perfusion, and reduce cerebral vasomotion creating white matter lesions in cortical regions of the brain integral in motor control. The summative effect would serve to alter gait performance. While high BP per se has been shown to be associated with reduced functional capacity, current gait speed, and longitudinal changes in gait speed over time, the relationship between absolute PP, as a proxy of ventricularvascular function, and long-distance gait speed in older adults has not been specifically explored. The purpose of this study was to examine the association of the steady and pulsatile components of BP with usual long distance gait speed measured during a 400-MWT in a large group of community-dwelling older adults at risk for mobility disability from The Lifestyle Interventions and Independence For BYL719 Elders Pilot investigation. We hypothesized that elevated PP would be associated with lower gait speed in older adults with mobility limitations. Older adults at risk for mobility disability comprise an ever growing proportion of the older adult population. This particular group is also at a higher risk for loss of independence, institutionalization, and death than older adults with higher physical function. Therefore understanding factors that may affect gait speed in older adults at risk for mobility disability is of significant clinical and practical concern. In support of previous work we noted several predictors of gait speed including age, body weight, handgrip strength, and diabetes mellitus. The novel aspect of the present investigation was that the pulsatile component of blood pressure was independently associated with long distance gait speed in community-dwelling older adults with mobility limitations, even after adjusting for other co-variables and the steady component of blood pressure. Moreover, ROC curve analysis revealed that PP added incremental value to slow gait prediction over that provided by age, body weight, muscular strength, and diabetes mellitus. PP is an easily obtainable measure of pulsatile afterload related to arterial stiffness, forward wave pressure and pressure from wave reflections. Brachial cuff-based measures of BP with subsequent calculation of PP do not require specialized equipment and are used in regular clinical practice giving this measure broad appeal. Elevated PP is associated with endothelial dysfunction, left ventricular hypertrophy, ischemia during exercise, and impaired ventricular relaxation, all clinically relevant facets of aging; all separately shown to be associated with reduced physical function.